Gait change since head injury
 

Has anyone else's gait been vastly altered since pre-injury? I now walk as if I have a pretty bad limp, but I am not sure why. I think it is because my balance is poor and I am always catching myself. I cannot even walk in a straight line.

I am a little concerned because the limp motion results in a gait with a fairly hard impact and quite a bit of head movement, which I think might be making my symptoms worse. Do you guys think that this could be the case? Also is this a common problem with people who have dizziness issues?

Yes. I think my gait changes are due to my vertigo.

I posted this article in one of the stickies at the top of the forum a while back ...

I've not re-read it for a while but it might be interesting for you.

http://neurotalk.psychcentral.com/post1133164-88.html


http://www.archives-pmr.org/article/...712-7/fulltext

Incidence of Gait Abnormalities After Traumatic Brain Injury
Archives of Physical Medicine and Rehabilitation
April 2009Volume 90, Issue 4, Pages 587–593

p.s. there are probably more recent studies since that one if you search for them in PubMed or other places.
I remember having a personal "wow" moment when I read this one above.

Wow very interesting articles, I am glad to know that it is not uncommon. Do you think that this exaggerated motion could be aggravating my symptoms? I tried to prevent myself from limping like this, but it seems to be just the way I walk now.

I don't think the force caused by the swaying is enough to hurt me though.

Do you think your problem is related to being dizzy or to something else?

I know that mine is a learned response because when my balance issues were at their worst it seems I changed the way I walk so that I don't fall. My feet are wider apart and I have a lot of problems with my feet now and also my calf muscles because I appear to be using muscles differently just to balance.

I also found a Webinar from the Vestibular Disorders Website in youtube. It's not directly associated with gait but it may be of interest to you since you mention dizziness.

>>> warning - the volume is really high on the video below. You'll need to turn it down. Ouch!

Concussion and Dizziness: How Are They Related
https://www.youtube.com/watch?v=PAgPtJ4crDw

Vestibular.org have some articles about gait.
If you type vestibular.org gait into your search engine it will bring up many varied articles including ones regarding vestibular therapy, gait analysis etc..

p.s. when I walk I try to focus on an object straight ahead of me so that I don't have too much head movement. I used to wear progressive lense glasses and i was moving my head up and down and too and fro just to see where I was walking and that made my balance much, much worse. I got rid of those and that helped me a lot as long as I keep focus on an object or mark straight ahead.

I will definitely look into that. I think I have always had a pre-disposition for dizziness, but my concussion just made the more prominent.

I mean from a brain perspective though, do you think the swaying and higher impact walking could be hurting my brain?

Sorry for the continual question, talking about my anxiety with others makes me feel a lot better.

I honestly can't see how it could hurt your brain, but I suppose there is the possibility that if you had neck problems it could affect the neck.

If you are concerned about the foot plant impacts having a negative impact on your recovery, I suggest you get some good running shoes with good resilient soles. This can take a lot of impact out of your foot plant.

There are some gait symptoms that are directly related to how the brain processes movement/proprioception, etc. More lift off the toes is not uncommon.

You may benefit from orthotics. They can help the foot support your weight better. The simplest would be the Dr Scholl's orthotic insoles that you can get at Walmart after standing on the Dr Scholl's orthotic measuring device. I have used similar orthotics for 30 years. They help the ball of my foot absorb more of my foot plant.

As Lara said, I doubt the impact is hurting your brain even though it may feel uncomfortable. A good Physiatrist (Physical Medicine and Rehabilitation Doctor) knows how to diagnose gait issues related to neurological problems.

I will definitely look into that Mark - thanks.

The problem is my anxiety magnifies this problem, and I know looking into it further would magnify that anxiety even more. So in your guys's opinions, there is absolutely no risk to my brain because of the limping?

I would think it more important to figure out why you're limping.

You're not going to hurt your brain from having a limp.

Are you limping due to pain or possible due to uneven hip/leg length..?

You may have gotten your c 1 c2 knocked out of alignment - and that may make a whole body tilt. also can cause dizziness..
Hips? shoulders even /level??
check in a mirror or have a friend compare when on flat floor bare feet or socks are best.

See an upper cervical chiro, or even an expert chiro that has training in atlas/axis..
youtube has videos so you can see what is is about..
more info-
www.upcspine.com

I had some gait changes. The exercise that corrected it was exagerated marching in place while having your arms doing the same just alternating of course.

Gait changes... yes!

I had major changes to my gait after my injury. I did nearly 3 years of rehab to try to correct this with no success.

There are many known causes of gait change and I'm sure many more that no one knows about too.

Some of the ones that haven't been mentioned.... sometimes after a TBI, there can be issues using your core muscles, which can affect your gait. If this is the issue, a physiotherapist can help you reconnect with those muscles.

For ME, this was not my issue... it took 3 years to finally see someone local about my vision. I could SEE fine, but after visual testing (neuro optometry) they discovered I have multiple vision issues. The one that affects my balance and my gait is visual midline shift.

Basically, non injured people know their "middle" is in front of their nose... when I was tested, I perceive my mid line or middle to be in front of my right eye.

I was then tested with prism lenses and magically my gait was fixed. So I've been wearing my prism glasses for almost a year now and as long as they are on, I can walk fine. Take them off and I need my cane. When they are off, my stance gets dramatically wider and I appear to "limp" also.

The limp part seems to be some sort of uncoordination, like my left leg just doesn't swing at quite the right time. Before my prism glasses, I had many people ask if I hurt my knee, hip, back, etc, because of my awkward gait.

Might be worth a try to see a neuro optometrist for testing if possible. My glasses were the first thing that's made a real difference for me. Very glad I no longer need my cane.

I do still have issues with falling down now and then, but not as often as without the glasses.

Best of luck to you.
Starr

Thanks for the helpful replies everyone. I actually was at just a regular check-up today and asked about my leg length in relation to each other, my doc immediately said, "your left leg is quite a bit longer than your right leg, didn't you know that?" The problem is I sustained my concussion right in the middle of puberty - so not only was I going through lots of physical and chemical changes because of that, but also the concussion.

Though now I seem to have hit a dilemma, since I am pretty sure my limp is caused by my difference in leg length and possibly my poor knee health, it will probably be unable to fix. I am still concerned about the effect that this will have on my brain health.

A difference in leg length will not effect your brain health. You can easily get a heel wedge to balance your leg length. There are more extreme ways to balance leg length but there is no reason to consider them nor worry about your leg length being an issue with your brain health.

What makes you think your concussion and puberty have a relation to the other concepts ? What is wrong with your knee ?

It would be worthwhile to ask your doctor for a referral to an orthotic specialist to make you a wedge. It will help your hips to stay healthy by resolving/reducing your limp.

MDs generally will not even mention upper cervical or even chiropractic care at all..., it is a competitive bias .:(

I would at least get an evaluation/assessment by a expert PT, or expert chiro and have them check your hips , knees , shoulders - before possibly getting foot wedge or such..

MDs will prefer to say a leg is longer , than admit the uneven hips might be the true cause ...

Yes, Jo.

I have "one leg a little longer" as told to me by many GPs.

The reality is that I have some mechanical problems in my spine including some injuries though. I have a mild scoliosis, spondylolisthesis (sliding L5/S1} and lordosis (aka swayback). In reality, one HIP is higher.

A really good Physiotherapist I found knew more about it all and how to help me than my doctor.

MY L5 is slightly forward or backward of center ( I should have paid more attention when looking at the xray ), and slips sometimes, I can feel it those times..:eek:

Good catch Jo.

ConcussedGuy17, It would be worthwhile to find a chiropractor who uses leg check who will be an expert at analyzing your spine as it impacts leg length. An upper cervical chiro would be worthwhile, too.